Unusual metastases in papillary microcarcinoma of thyroid

Ajit, Nimmagadda; Mohan, VS Krishna; Manthri, Ranadheer Gupta; Kalawat, Tekchand

doi:10.4103/ijnm.ijnm_127_18

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…Rare distant metastatic locations of PTC that have been sporadically reported include the following: liver, pancreas, spleen, kidney, adrenal gland, brain, cerebellum, skeletal muscle, parotid gland, skin, and so on. [5][6][7][8][9][10][11][12][13][14] Less than 1/2,000 thyroid tumours initally manifest as adrenal metastasis [15] and they are usually multiple, bilateral and often associated with lung or bone metastases. [16,17] In our case, metastasis was solitary and unilateral in the left adrenal gland without evidence of involvement of other common locations like lung or bone.…”

Section: Discussionmentioning

confidence: 99%

Papillary thyroid carcinoma presenting as metastases at unexpected sites: Report of two cases

Thomas

Manuel

2020

DCC

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Papillary thyroid carcinoma (PTC) is the most common form of differentiated thyroid carcinoma (DTC). It is generally confined to the neck with or without spread to regional lymph nodes. Distant metastases is rare, if occurs, it usually involves lung and bone. Additional locations have only been sporadically reported and were identified during the course of follow-up, subsequently to a thyroid surgery. Distant metastases as the initial presentation of PTC is a rare event. We, herein, report two cases of PTC presenting initially as metastases at unusual sites and discuss the importance of meticulous histopathological and immunohistochemical examination in such situations. Our aim is to increase awareness of the unique possibility of PTC presenting as metastatic deposits at unexpected sites.

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Section: Discussionmentioning

confidence: 99%

Papillary thyroid carcinoma presenting as metastases at unexpected sites: Report of two cases

Thomas

Manuel

2020

DCC

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“…The surgical management in these patients included hemithyroidectomy in 29.2% (14), subtotal thyroidectomy in 20.8% (10), near total thyroidectomy in 6.25% (3), and total thyroidectomy in 43.75% (21). Concurrent neck LN dissection was done in 39.6% (19) of these patients.…”

Section: Surgical Managementmentioning

confidence: 99%

“…[8][9][10] There are not many studies on PMC in Indian literature till date. [11][12][13][14][15] In this article, we have analyzed the prognostic significance of various clinicopathologic parameters including BRAF V600E mutation by immunohistochemistry (IHC) in PMC.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Various Clinicopathologic Parameters and BRAF V600E Mutation in Papillary Thyroid Microcarcinoma—An Observational Study

Ayesha

Hui

Uppin

et al. 2023

Indian J Med Paediatr Oncol

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Introduction A specific subset of papillary microcarcinoma of thyroid (PMC) can metastasize regionally and to distant organs, and thus, have a significant effect on the overall survival of the patient cohort. Objectives We aim to analyze the prognostic significance of various clinicopathologic parameters including BRAFV600E mutation by immunohistochemistry in PMC, in order to identify the subset of cases with aggressive behavior. Materials and Methods Data regarding the PMC cases was retrieved retrospectively from medical records. The clinicopathologic factors like age, tumor size, focality, capsular invasion, histologic subtype, lymphovascular invasion, perithyroidal fat invasion (PTFI), lymph node (LN) metastasis, and distant metastasis were studied in depth. Tissue microarray was constructed to perform immunohistochemistry with CK19 and BRAFV600E. Information regarding overall survival (OS) and development of metastasis, if any, was noted. Chi-squared test was performed to know the association between various factors. To determine odds ratio, logistic regression was done. Survival analysis was done using Kaplan–Meier and Cox-regression analysis. Results PMC was diagnosed in 48 patients (M:F = 1:2.4), between 22 and 70 years of age (median = 46.5 years). Chi-squared test showed significant association of fibrosis with tumor size more than or equal to 0.5 cm, infiltrative borders, PTFI, and LN metastasis. Tumor size was also associated with infiltrative borders; and LN metastasis with PTFI. BRAFV600E positivity showed significant association with histologic pattern, PTFI and distant metastasis. On logistic regression, tumor size showed significantly increased odds ratio with presence of fibrosis and infiltrative borders. Presence of fibrosis also showed significant association with infiltrative borders and LN metastasis. BRAF V600E had significantly increased odds ratio with histologic pattern, both on univariate and multivariate logistic regression. Kaplan–Meier analysis revealed significantly reduced OS with presence of LN metastases (p-value = 0.050, log-rank test). Cox-regression did not yield a significant hazard ratio for the various factors studied. Conclusion This study shows association of LN metastasis with intratumoral fibrosis, PTFI and reduced OS. Intratumoral fibrosis was also associated with tumor size more than 5mm, infiltrative borders and PTFI. Increasing tumor size and infiltrative borders also showed an association. In addition, BRAFV600E positivity was found to be associated with histologic pattern, PTFI and distant metastasis.

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“…Metastases to intraabdominal organs are extremely uncommon. 2 Tumourigenesis is the result of imbalance between elaborate cancer-promoting and cancer-inhibiting molecular pathways. Cancer formation, progression, and metastasis are all impacted by inflammation.…”

Section: Introductionmentioning

confidence: 99%

A study of tumour infiltrating lymphocytes and neutrophil to lymphocyte ratio in papillary carcinoma thyroid

Jaleel

Saldanha

2023

Int J Res Med Sci

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Background: Papillary thyroid carcinoma accounts for 70-80% of all diagnosed thyroid carcinomas. Immune response including systemic inflammation is thought to be essential for suppression of carcinogenesis. This study aims to correlate the tumour infiltrating lymphocytes (TIL) and neutrophil to lymphocyte ratio (NLR) in various demographic data and histomorphological features of papillary carcinoma thyroid. Methods: A total of 60 cases of papillary carcinoma were taken from a period between January 2018 and July 2021. TIL was analyzed as diffuse or focal at the area of highest concentration and was graded subjectively as: absent (no lymphocytes), mild (1-10%), moderate (>10-50%) and dense (>50%). NLR was calculated as the neutrophil count divided by the lymphocyte count, based on the preoperative complete blood cell counts. Results: The cases belonged to age group varying from 20 to 75 years with female preponderance (88.3%). In this study, there was significant correlation between TIL and tumour stage with a p value of 0.001. Lower the tumour stage, higher was the concentration of TIL. A cut of value of 2.17 was taken for NLR. Cases with diffuse, moderate to dense peritumoural lymphocytes had lower NLR and were statistically significant. High NLR was also seen in higher TNM stage. On the other hand, there were no association with gender, age, tumour size, histological subtype and focality with NLR. Conclusions: As an index of inflammation, tumour infiltrating lymphocytes and NLR can be considered. We found increased TIL in lower tumour stage and increased NLR values in higher tumour stages.

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Unusual metastases in papillary microcarcinoma of thyroid

Cited by 8 publications

References 10 publications

Papillary thyroid carcinoma presenting as metastases at unexpected sites: Report of two cases

Papillary thyroid carcinoma presenting as metastases at unexpected sites: Report of two cases

Prognostic Significance of Various Clinicopathologic Parameters and BRAF V600E Mutation in Papillary Thyroid Microcarcinoma—An Observational Study

A study of tumour infiltrating lymphocytes and neutrophil to lymphocyte ratio in papillary carcinoma thyroid

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